Recurrence rate with new GD diagnosis?

[mkvh]

Hey ladies! It's been a long time since I spent much time here, probably about 4.5 years ago during my 2nd pregnancy. I am now pregnant with #4 (and final) and have a question.

I had severe pre-e and post-partum pre-e with #1 and mild gestational hypertension at term with #2. My third pregnancy was normotensive and thoroughly uncomplicated. Now, I am 32w with #4. I failed my 1 hour GTT and have been monitoring my blood glucose levels at home since. They are clearly in the range of GD, so I will likely be getting an official diagnosis come my next OB appointment. Fortunately, they seem to be diet-controlled thus far.

My concern is this: since there is an increased risk of pre-e with GD, AND I have a history of severe pre-e, how does that up my odds of pre-e this time?

Thanks!

[angieb]

I had GD (probably) with DS (like you, failed the 1 hour, opted to skip the 3 hour, had some high fasting numbers but my meal numbers were very easily controlled even not following the diet very closely so not positive that I wouldn't have passed the 3 hour.) In any case, they considered that I had it and I ended up on oral meds for the fasting numbers because they never did get very good regardless of what we tried. DS was born healthy at 36+2 with no problems, after I had had severe pre-e and HELLP at 23 weeks with my first pregnancy.

So yeah, it does raise your risk, but it's not a guarantee. I think we've had some other posters here that had GD in subsequent pregnancies but did not get pre-e.

[alviarin]

I've been wondering the same thing. I have a recent gestational diabetes (GD) diagnosis as well.

My OB thinks as long as my glucose levels stay well controlled it won't increase my risk of pre-e. Though I still have good odds of developing pre-e this pregnancy due to my history of pre-e plus chronic hypertension.

If GD was for sure an *independent* risk factor it might raise our risk of pre-e, but since women with insulin resistance might be more likely to develop pre-e to begin with and the placenta can cause GD it might be part & parcel of our overall underlying risk of re-occurence, know what I mean?
http://www.preeclampsia.org/forum/viewt ... 93&p=58186

One study found treatment of even mild GD lowered pregnancy risks: http://www.preeclampsia.org/forum/viewt ... 50&p=35668

I hope this helps, good luck!

[mkvh]

Hrmmm....very interesting! So it well may be that I have GD *because of* my pre-e history (or at least due to whatever causes my propensity for pre-e in the first place). Funnily enough, I failed the 1 hour GTT with my first two pregnancies as well, both of which had hypertensive issues but passed it easily in my normotensive pregnancy. Darn crappy placentas!!

Let's hope that we can both keep our glucose levels in check, alviarin, and keep pre-e at bay!

[alviarin]

Here's hoping!